Hospital's emergency voucher system falls flat

19:19, May 12 2013

A voucher scheme at Blenheim's emergency department has shown that people with minor ailments use the acute hospital ward for convenience rather than financial hardship, as was previously thought by health organisations in Marlborough.

Marlborough Primary Health Organisation chief executive Beth Tester said people used Wairau Hospital's emergency department when they couldn't see their doctor that day.

One man, with a GP appointment booked for 3pm, showed up at accident and emergency because his ferry was at midday, Ms Tester said.

The emergency department voucher scheme, operated by the Marlborough Primary Health Organisation, is designed to encourage people to visit their GP first.

The voucher is for patients with a community services card who do not need immediate treatment. It grants the patient a free consultation with their doctor within two days and the PHO reimburses the practice for that consultation.

Ms Tester said no vouchers had been handed out in Marlborough since the scheme started in January.


The same initiative was used in other parts of the country and the uptake was virtually non-existent, she said.

"I think one area handed out two vouchers in a year," she said. "It's quite interesting because the scheme was developed on the premise that people were turning up at the emergency department because they couldn't afford a GP visit."

She had asked emergency staff if they were asking "the difficult questions" about why people were presenting at the emergency ward, Ms Tester said.

"Nurses don't like to ask [about people's financial situation] but they said they were."

The initiative would remain in place despite its lacklustre performance, Ms Tester said.

The PHO and Nelson Marlborough District Health Board were developing a marketing-style campaign to teach people when to use the emergency department, she said.

A new triage system using St John paramedics to redirect patients to GP clinics was also being considered, she said.

But GPs didn't have the infrastructure or processes in place to take ambulance patients, she said. They would need stretcher access and ambulance bays.

"It wouldn't be huge volumes [of patients] per practice but if they all came on board that would make a difference."

Emergency department clinical head Andrew Morgan said it was widely believed people used the department because it was free.

"That's probably not as strong a driver as you might think," he said.

A lack, or perceived lack, of access to primary care was a more likely reason, Mr Morgan said.

"We have gone through a period where it was difficult to enrol with a GP, never mind be seen by one. People often do not think they will get an appointment."

A lot of ailments seen at the emergency department, like back pains, strains and sprains, could be treated by a doctor, he said.

"People should get care in the best place, and your GP is a better place for some medical conditions."

The Marlborough Express